Consensus Interferon Plus Ribavirin for Hepatitis C Genotype 3 Patients Previously Treated With Pegylated Interferon Plus Ribavirin

Abstract

BackgroundNot enough data are available about the effectiveness of consensus interferon (CIFN) among HCV genotype 3 patients who failed to respond to pegylated interferon and ribavirin.ObjectivesWe aimed to assess the efficacy and safety of CIFN and ribavirin in non-responders and relapsers to pegylated interferon with ribavirin therapy.Patients and MethodsThis open-label investigator-initiated study included 44 patients who received CIFN 15 µg /day plus ribavirin 800-1200 mg daily. In patients with an early virological response (EVR), the dose of CIFN was reduced to 15 µg thrice a week for further 36 weeks. Patients with delayed virological response continued to receive daily CIFN plus ribavirin to complete 48 weeks. The patients were considered “non-responders” if there were less than 2 log reduction in HCV RNA at 12 weeks and detectable HCV RNA at 24 weeks.ResultsTwenty-four patients (55%) were non-responders and 20 patients were relapsers to the previous treatment with pegylated interferon plus ribavirin (mean age 43.6 ± 9.4 years, males 25 (57%)). Nine patients were clinically cirrhotic (Child A). End of treatment virological response was achieved in 19 (43.1%) patients and sustained virological response (SVR) occurred in 12 (27.3%). Out of these 12 patients, eight were non-responders and four were relapsers to the previous treatment. Advanced fibrosis or clinical cirrhosis was associated with low SVR. Adverse events were fever, myalgia, anorexia, depression, and weight loss. Two patients received granulocyte colony stimulating factor for transient neutropenia. Seven patients were given erythropoietin to improve hemoglobin, and six were treated for mild depression. Two patients developed portosystemic encephalopathy.ConclusionsMore than one-quarter of treatment-experienced patients with HCV genotype 3 achieved SVR after re-treatment with consensus interferon plus ribavirin.

Aspects of interferons (IFNs) interfering with HCV-G1 response

“…The Nonresponsiveness to IFNs is fairly common with varying rates in HCV infection. Response to IFN-α is observed in nearly 40-50% of patients with HCV infection, with improvement in rates by the addition of Ribavirin [9].…”

Evaluating the ion exchange chromatography for matrix‐assisted PEGylation and purification of consensus interferon

“…By organizing the total of 166 amino acids for all 13 IFN-α subtype keeping in view the more often signified amino acids from numerous IFN-α nonallelic subtypes at each position, a consensus sequence was determined. A commercially available U.S. Food and Drug Administration (FDA)-approved cIFN, Infergen (IFN alfacon-1 or cIFN) has 5-20-fold highest biopotency (higher antiproliferative and antiviral activity) [5,6]. cIFN is a second-generation type I IFN, and it is artificially formed by recombinant technology, which is created by the dint of multiple sequence alignment tools [7].…”